Provider Demographics
NPI:1659420909
Name:TESSIER, PETER (BSW)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:TESSIER
Suffix:
Gender:M
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2655 BRADFORDT DR
Mailing Address - Street 2:
Mailing Address - City:WEST MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-7450
Mailing Address - Country:US
Mailing Address - Phone:321-729-6527
Mailing Address - Fax:
Practice Address - Street 1:3270 SUNTREE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7532
Practice Address - Country:US
Practice Address - Phone:321-752-3170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker